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The National Cancer Institute (NCI) recently released Cancer Progress Report 2001-the first in a new series of reports designed to make scientific information on cancer more accessible and understandable. The new report describes and illustrates the nation’s progress in reducing the cancer burden across the full cancer continuum, from prevention through death.

BUFFALO, New York-Median progression-free survival has still not been reached after 6 years median follow-up of 40 patients with low-grade or follicular non-Hodgkin’s lymphoma (NHL) treated in the first clinical trial of rituximab (Rituxan) in combination with CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], and prednisone), Myron S. Czuczman, MD, reported.

ERFURT, Germany-Interim data from a randomized phase III study show that MCP (mitoxantrone [Novantrone], chlorambucil [Leukeran], prednisolone) with or without rituximab (Rituxan) is active in advanced indolent lymphomas. Michael Herold, MD, reporting for the Ostdeutsche Studiengruppe Haematologie/Oncologie (OSHO), said, "The response rate of 81% is within the range of that seen with standard therapies. The complete response (CR) rate of 40% was highly encouraging, particularly given the multi-institutional setting of this study. To date, no significant change in response has been seen with the addition of rituximab to MCP, but further follow-up is needed to determine if the addition of rituximab will improve the duration of response."

BETHESDA, Maryland-The National Cancer Institute’s Cancer Progress Report 2001-a living document that the Institute will update once or twice a year online and every few years in printed form-renders a mixed judgment about the nation’s success in reducing the burden of cancer.

MUNICH-Adding rituximab (Rituxan) increases the efficacy of FCM (fludarabine [Fludara], cyclophosphamide [Cytoxan, Neosar], mitoxantrone [Novantrone]) in relapsed or refractory follicular (FCL) or mantle cell lymphomas (MCL), reported Martin Dreyling, MD. "This is the first randomized study that proves the benefit of rituximab in indolent lymphomas," said Dr. Dreyling, who reported on behalf of the German Low Grade Lymphoma Study Group (GLSG), directed by W. Hiddemann, Munich, at the 43rd Annual Meeting of the American Society of Hematology.

HOUSTON-A modified "hyper-CVAD" (cyclophosphamide [Cytoxan, Neosar], vincristine, doxorubicin [Adriamycin], dexamethasone) regimen, which included the addition of rituximab (Rituxan) for CD20-positive patients and the use of laminar airflow rooms for patients who were elderly or had poor performance status, reduced induction mortality in older patients with acute lymphoblastic leukemia (ALL). Overall mortality was not changed, because a number of patients died of other causes while in complete remission (CR).

WASHINGTON-If Katie Couric’s on-air exam made colonoscopy a household word, the time may have come for a nationwide campaign to prevent cancer. Any national program for preventing cancer must be relevant, collaborative, and

HOUSTON-Adding rituximab (Rituxan) to fludarabine (Fludara)/cyclophosphamide (Cytoxan, Neosar) (FCR) prolongs survival in patients with relapsed chronic lymphocytic leukemia (CLL), according to Guillermo Garcia-Manero, MD. Dr. Garcia-Manero is assistant professor in the Department of Leukemia at The University of Texas M. D. Anderson Cancer Center in Houston. He presented updated data on this study in a poster at the 43rd Annual Meeting of the American Society of Hematology.

ORLANDO-A large percentage of HIV-infected patients present with non-Hodgkin’s lymphoma (NHL) as their initial AIDS-defining illness, according to a retrospective study in patients with HIV-related systemic NHL at one institution. Garrett R. Lynch, MD, reviewed the data at the American Society of Hematology (ASH) annual meeting (abstract 1434).

The cancer community is expressing unanimous approval of President George W. Bush’s appointment of Andrew von Eschenbach, MD, as director of the National Cancer Institute (NCI). Dr. von Eschenbach was director of the Genitourinary Cancer Center and Prostate Cancer Research Program at the University of Texas M. D. Anderson Cancer Center. "[His] extensive experience in cancer research, treatment, and prevention has prepared him extraordinarily well to head the NCI," said Larry Norton, MD, president of the American Society of Clinical Oncology. "As both a recognized leader in the oncology community and as a cancer survivor, Andy brings a distinctive perspective to this position."

LYON, France-A study from the International Agency for Research on Cancer (IARC) shows a higher cancer prevalence in the developed world, primarily because of longer life expectancy in richer countries (Int J Cancer 97:72-81, 2002).

LYON, France-A year after he presented interim data indicating that R-CHOP produced better results than CHOP alone against aggressive B-cell lymphomas in the elderly, Bertrand Coiffier, MD, reported that the benefits of the combination of rituximab (Rituxan) plus CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], prednisone) increased over time.

SILVER SPRING, Maryland-The Oncologic Drugs Advisory Committee (ODAC) sent the Food and Drug Administration a mixed message in its votes regarding a new indication for Gliadel Wafer (polifeprosan 20 with carmustine implant, Guilford

ORLANDO-In advanced-stage low-grade non-Hodgkin’s lymphoma (NHL), a regimen of fludarabine (Fludara) plus mitoxantrone (Novantrone) followed by rituximab (Rituxan) is highly effective and well tolerated, according to study results presented at the 43rd Annual Meeting of the American Society of Hematology (ASH abstract 2534).

BOSTON-A rare pediatric leukemia, previously thought to be a subset of acute lymphoblastic leukemia (ALL), is actually a distinct form of the disease, according to investigators who used gene chips to create and contrast genetic profiles of cancer cells.

New research from the AIDS Institute at the University of California, Los Angeles (UCLA), reveals that stress enables the human immunodeficiency virus (HIV) to spread more quickly in infected persons and prevents antiretroviral drugs from restoring immune system function. The study, which was reported in the Proceedings of the National Academy of Sciences (98:12695-12700, 2001), is the first to pinpoint the molecular mechanisms linking stress and HIV infection. "Popular science has widely suspected that stress weakens the immune system," said Steve Cole, MD, lead author and UCLA assistant professor of hematology-oncology. "Now we’ve uncovered two reasons why."

The Association of Community Cancer Centers (ACCC), a national interdisciplinary organization defining quality cancer care, has launched a public policy website-www.accc-cancer.org/publicpolicy/-dedicated to the regulatory and legislative issues affecting patients with cancer. The website was developed to assist in educating patients and their families about public policy that has an impact on cancer care.

SAN DIEGO--To relieve the anxiety and frustration cancer patients may feel when being put on a waiting list for enrollment into a phase I trial, clinical trials managers at Vanderbilt have developed wait list guidelines driven by compassion and ethics,

COLOGNE, Germany-Combining rituximab (Rituxan) with fludarabine (Fludara) is a feasible, effective strategy in treating chronic lymphocytic leukemia (CLL), as it produces a 90% response rate and does not increase infection risk beyond that seen with fludarabine alone, Holger Schulz, MD, reported in a poster presentation at the 43rd Annual Meeting of the American Society of Hematology. Dr. Schulz is in the Department of Hematology/Oncology at the University of Cologne, Germany.

ORLANDO, Florida-Updated data from two separate studies ratify earlier results showing that following CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], prednisone) with radiation improves results for patients with early- or limited-stage non-Hodgkin’s lymphoma (NHL).

A new study published in the Journal of Clinical Oncology (19:3918-3928, 2001) reported that radioimmunotherapy with tositumomab/iodine-131 tositumomab (Bexxar), produced more durable complete or partial clinical responses in patients with low-grade and transformed low-grade non-Hodgkin’s lymphoma (NHL) than did their last round of chemotherapy. All patients in the study had chemotherapy-refractory NHL. Typically, response rates and durations of response in refractory patients decline with each successive therapy, but in this study, the tositumomab/iodine-131 tositumomab combination was shown to reverse the expected outcome.

WASHINGTON-"Cancer prevention now requires that we move from thought to reality," said Carolyn Aldigé, founder and president of the Cancer Research Foundation of America (CRFA). "This mean a new paradigm of the health care system, rather than just taking care of sick people. Treatment of advanced disease has less impact than prevention."

NASHVILLE, Tennessee-A pilot study of rituximab (Rituxan) as first-line therapy for small lymphocytic lymphoma (SLL) or chronic lymphocytic leukemia (CLL) found an overall response rate of 56%, according to John Hainsworth, MD, director of clinical research at the Sarah Cannon Cancer Center in Nashville, Tennessee. Dr. Hainsworth discussed this work in a poster session at the 43rd Annual Meeting of the American Society of Hematology.

HOMBURG, Germany-After conducting trials comparing CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], prednisone) with and without etoposide and varying time intervals, the German High-Grade Non-Hodgkin’s Lymphoma Study Group concluded that CHOP plus etoposide is the new standard regimen for younger patients with low-risk non-Hodgkin’s lymphoma (NHL), and CHOP at 2-week intervals is the new standard regimen for aggressive NHL in older patients.

CHICAGO-Once-a-week dosing of recombinant human erythropoietin (epoetin alfa, Epogen, Procrit) is as effective as thrice-weekly dosing in improving hemoglobin (Hb) levels in HIV-positive patients who are anemic, Howard A. Grossman, MD, said at the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC abstract 254).

ORLANDO-The investigational, single-dose cytokine pegfilgrastim worked as well as filgrastim (G-CSF, Neupogen) in decreasing the duration of severe neutropenia following chemotherapy in patients with relapsed or refractory non-Hodgkin’s lymphoma (NHL) or Hodgkin’s disease.

For the past 20 to 30 years, enormous resources have been directed toward the development of effective cancer immunotherapies. The interest in immunotherapeutic approaches comes from the potential specificity imparted by the recognition of tumor-specific antigens combined with the powerful cytolytic properties of cellular and humoral immune effector arms. Earlier attempts to induce and/or expand tumor antigen-specific immune responses in patients involved the systemic administration of cytokines such as interleukin-2 (Proleukin), or immunization with vaccines prepared from whole tumor cells or tumor cell lysates admixed with powerful immunologic adjuvants (stimulators). Unfortunately, only limited efficacy was achieved.

The title of the article by Dr. Stephen Sagar, "Carcinomatous Meningitis: It Does Not Have to Be a Death Sentence" is very provocative. Most oncology specialists consider leptomeningeal dissemination of cancer as an indication of end-stage disease, particularly in patients with solid malignancies. More than 70% of patients found to have neoplastic meningitis have evidence of concurrent progressive systemic disease.[1] Although neoplastic meningitis is thought to have less of an impact on survival in patients with lymphomas or leukemias, the presence of tumor cells in the cerebrospinal fluid (CSF) of these patients significantly complicates the treatment regimen.

The association between HIV infection and the development of cancer was noted early in the acquired immunodeficiency syndrome (AIDS) epidemic. The AIDS-defining malignancies are Kaposi’s sarcoma, intermediate- or high-grade B-cell non-Hodgkin’s lymphoma (NHL), and cervical cancer. All of these cancers feature specific infectious agents in their etiology. These agents are human herpesvirus 8/Kaposi’s sarcoma-associated herpesvirus, or HHV-8/KSHV (implicated in Kaposi’s sarcoma), Epstein-Barr virus, or EBV (in primary central nervous system lymphoma and a subset of systemic B-cell NHL) and human papillomavirus, or HPV (in cervical cancer).[1]

With this insightful manuscript, Drs. Termuhlen and Kemeny shed some light on the surgical management of older cancer patients. The authors highlight pitfalls in patient selection and offer proposals to improve the surgical oncologist’s approach to patient care. They review the role of curative surgical management of the most common forms of cancer in the elderly, while emphasizing the role of surgical palliation to improve the quality of life of older cancer patients.